الفهرس 
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Abstract
T1DM is an autoimmune disease defined by immune-mediated recognition of islet cells by auto reactive T cells. Cytokines are necessary for coordinating intricate multicellular interactions between pancreatic β-cells -cells and immune cells in the pancreas (T1DM) as well as several studies have recently re-emphasized the importance of the haematological profile in the early detection of diabetic inflammations and consequences.
The goal of this study was to explore at the link between haematological indices disorders and oxidative stress in children with (T1DM), as well as the role of cytokines such as interleukin (IL)-21, IL-23, and IL-2 in T1DM and their interaction with dyslipidemia.
A total of 70 children with T1DM and 30 healthy controls were included in the study. Children with T1DM were separated into two groups: those who had recently been diagnosed (n=21) and those who had been diagnosed for a longer time (n=49). Diabetic children’s fasting blood sugar and glycosylated hemoglobin (newly and older), fasting blood glucose (FBG) was determined in both T1DM and control children’s plasma samples. Glycosylated hemoglobin (HbA1c). Moreover, nitric oxide (NO) and lipid peroxidation, (MDA) level. Detect triglyceride (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-c) levels. Low-density lipoprotein cholesterol (LDL -c) level was calculated. Serum levels of IL-2, and IL-21was detected by ELISA. IL-21 and IL-23 mRNA expression extracted from the patient’s peripheral blood lymphocytes.
FBS and HbA1c levels were considerably higher in children with newly diagnosed T1DM and older children with T1DM than in control children.C-peptide levels were lower in children with newly diagnosed T1DM, but considerably higher in children with older diagnosed T1DM. While T.C. and LDL cholesterol levels were consistently greater than control in children with newly diagnosed T1DM and older diagnosed T1DM. While T.C. and LDL cholesterol were non-significant in children with newly diagnosed T1DM when compared to children with older diagnosed T1DM, HDL cholesterol was highly relevant in children with newly diagnosed T1DM and older diagnosed T1DM. As well as, T.G. was considerably higher in children with newly diagnosed T1DM and older children with T1DM than in control children.
Creatinine levels in older diagnosed T1DM were considerably higher than control, however creatinine levels in newly diagnosed T1DM children were non-significant when compared to older diagnosed T1DM children and newly diagnosed T1DM children when compared to control. Microalbuminuria was substantially higher in older T1DM patients than in newly diagnosed patients and controls. While, Microalbuminuria was shown to be non-significant in children with newly diagnosed T1DM when compared to control children.
IL-21 and IL-2 levels were substantially higher in children with newly diagnosed T1DM than in children with older diagnosed T1DM, but IL-21 and IL-2 levels were non-significant in children with newly diagnosed T1DM compared to children with older diagnosed T1DM. The level of IL-23 expression in children with newly diagnosed T1DM and older diagnosed T1DM was significantly higher than in the control group. The level of IL-23 expression was also significantly lower in newly diagnosed T1DM children than in older diagnosed T1DM children. IL-21 expression levels were significantly higher in children with newly diagnosed T1DM and older children with T1DM than in control children.
NO and MDA levels in children with newly diagnosed T1DM and older diagnosed T1DM were significantly higher than control, although NO and MDA levels in children with newly diagnosed T1DM were non-significant In regards of red blood cell indices, RBC count was significantly lower in older T1DM patients, whereas values were significantly lower in newly diagnosed T1DM patients compared to healthy controls. Furthermore, T1DM children’s HB and PCV levels were significantly lower than healthy children’s when compared to older diagnosed T1DM. Additionally, RDW increased significantly in both T1DM groups, whereas platelet count decreased significantly in older diagnosed T1DM. When compared to healthy controls, the two T1DM groups had significantly higher MPV and PDW levels. The platelet/lymphocyte (P/L) ratio, on the other hand, was significantly higher in older T1DM patients compared to the healthy group.
In terms of leukocytes count, the findings demonstrated a significant increase in leukocytes and neutrophils among newly diagnosed T1DM children, whereas lymphocytes and monocytes counts, as well as the neutrophil/ lymphocyte ratio, showed no significant differences when compared to healthy controls. Furthermore, when compared to the heal group, both groups’ lipid peroxidation biomarker (MDA) and NO levels were significantly higher. MDA also had positive correlations with PCV, RBCs, and microalbuminuria, while it had a negative correlation with MCV.
Regarding diabetic children, IL–21 mRNA expression and IL-23 mRNA expression showed a positive correlation with FBS,T.C and T.G While, a negative correlation with C-peptide was observed In addition, On the other hand, IL-2 level showed a positive correlation with C-peptide, while, a negative correlation has been recorded with FBS, T.C and T.G.
In Conclusion, in T1DM patients, there was a synergistic association between IL-21 and IL-23, as well as an antagonistic effect of IL-2. Furthermore, dyslipidemia was correlated to IL-2, IL-21, and IL-23 in T1DM patients. The current findings revealed a link between abnormalities in haematological indices and oxidative stress status in children with T1DM, highlighting the essential role of oxidative stress in T1DM haematological abnormalities. These findings could have clinical consequences, as cytokine levels and haematological indices could be used as early detection markers of children with T1DM at risk of diabetic complications Children with T1DM may require antioxidant supplements to decrease oxidative stress and delay or avoid diabetes complications.